Pain Medicine

Pain medicine is a specialist area of anaesthetics. Basic and Intermediate training in Pain Medicine happens as part of the wider anaesthetics training programme. Higher Pain Training is an optional unit essential for all trainees who would like to progress to Advanced Pain Training; the RCoA and Faculty of Pain Medicine recommend that this is the minimum level of competency required for trainees considering a future consultant post with an interest in Acute Pain. 


Advanced Pain Training is delivered over a minimum 12 month period in designated multi-disciplinary specialist centres where trainees are expected to undertake a wide variety of training in pain management spanning the full range of pain medicine treatment options/plans. Advanced Pain Training is considered the minimum required for those aiming for a consultant appointment with sessions in pain medicine.


All trainees entering Advanced Pain Training will be required to take the examination (MCQ paper and Structured Oral Examinations) in order to achieve the FFPMRCA:


  • All CT 1/2 need to undergo basic level training in pain medicine and where possible this should be in a single block as specified in the CCT in Anaesthetics document. The aim is for the trainee to competently assess and manage acute post-operative pain and acute non post-operative pain along with possessing sufficient knowledge to provide a basic understanding of the management of chronic pain in adults.
  • All ST 3/4 need to undergo a supervised period of 4-12 weeks intermediate training in pain medicine as specified within the CCT in Anaesthetics document. Ideally this should be in a single block. The aim is for the trainee to be an effective member of the acute pain team and competent in the assessment and management of acute surgical and non- surgical and acute or chronic pain in most patient groups. They should also have a knowledge of the assessment, management and wider treatment options for chronic and cancer pain in adults and be aware of the need for multi-professional input and to employ this in the management of chronic and cancer pain.
  • Higher training in pain medicine is essential for those wishing to progress to advanced training. Higher training is considered a minimum for trainees considering a consultant post with an interest in acute pain. It is optional for ST 5/6/7.


Recruitment into Higher and Advanced Pain Medicine training posts mostly happens locally, but some centres advertise centrally through NHS Job website ( Recruitment to Higher Pain Training posts is much more informal; it is recommended that you contact your Local Pain Medicine Educational Supervisor (LPMES) and Regional Advisor in Pain Medicine (RAPM) to discuss your options and how this would fit into your training programme. In West Midlands, Birmingham and Warwickshire Schools have the resources to offer Advanced Pain Training.  Alternatively, some prefer overseas training (


A plethora of information on pain training is available at:


Trainees interested in advancing their career in pain medicine are advised to liaise with the LPMES to explore different training opportunities.


Dr Shyam Balasubramanian MBBS MD MSc FRCA FFPMRCA

Consultant in Pain Medicine & Anaesthesia, UHCW NHS Trust, Coventry

Regional Advisor in Pain Medicine, West Midlands

Additional Resources

Training in Intermediate Pain Medicine
Guidance leaflet for trainees undertaking their Intermediate Pain module.
Intermediate Pain Leaflet.pdf
Adobe Acrobat document [498.8 KB]
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